腹腔镜与开放手术治疗小于3岁儿童腹股沟型隐睾的对比研究  

Laparoscopic versus open orchiopexy for inguinal cryptorchidism in children under 3 years

作　　者：周玉 牟亚汝 丁奕名 牛泽永 辛鹏鸽 李爱武[1] 王健[1] ZHOU Yu;MOU Yaru;DING Yiming(Department of Pediatric Surgery,Qilu Hospital of Shandong University,Jinan 250012,China)

机构地区：[1]山东大学齐鲁医院小儿外科,山东济南250012

出　　处：《腹腔镜外科杂志》2025年第2期123-127,共5页Journal of Laparoscopic Surgery

基　　金：山东省自然科学基金面上项目(ZR2022MH276)。

摘　　要：目的:比较腹腔镜睾丸下降固定术与开放手术治疗小于3岁儿童腹股沟型隐睾的疗效,总结腹腔镜手术的优势与临床经验。方法:收集2018年1月至2023年1月收治的320例0.5~3岁腹股沟型隐睾患儿的临床资料,根据手术方式分为腔镜组与开放组;另以年龄1.5岁为界分为两个亚组,A组0.5~1.5岁,B组1.5~3岁。系统性对比分析两组术前、术中、术后随访资料。结果:两组术前资料差异无统计学意义。腔镜组手术时间长于开放组,手术切口、住院时间短于开放组;两组术中出血量差异无统计学意义。术中均无严重并发症发生;术后随访,两组阴囊水肿、鞘膜积液、切口感染、睾丸萎缩、复发率差异无统计学意义。术后12个月,腔镜组睾丸位置低于开放组。A亚组睾丸体积腔镜组与开放组差异无统计学意义,B亚组睾丸体积腔镜组大于开放组(P=0.007)。结论:腹腔镜与开放睾丸下降固定术治疗腹股沟型隐睾均是有效的,腹腔镜手术具有康复快、切口美观、并发症较少的优点,睾丸下降程度好于开放手术。相较1.5~3岁的患儿,0.5~1.5岁进行手术治疗的并发症发生率更低。Objective:To compare the clinical outcomes of laparoscopic orchiopexy and open surgery for the treatment of inguinal cryptorchidism in children under 3 years of age,and to summarize the advantages and clinical experience of laparoscopic surgery.Methods:Clinical data of 320 children aged 0.5 to 3 years with inguinal cryptorchidism treated between Jan.2018 and Jan.2023 were retrospectively analyzed.Patients were divided into laparoscopic and open surgery groups based on surgical approach.Additionally,patients were stratified into two subgroups by age:Group A(0.5~1.5 years)and Group B(1.5~3 years).Preoperative,intraoperative,and postoperative follow-up data were systematically compared between the groups.Results:There were no significant differences in preoperative characteristics between the two groups.The laparoscopic group had longer operative time but smaller incisions and shorter hospital stay than the open surgery group.Intraoperative blood loss did not differ significantly between the two groups,and no serious complications occurred during surgery.During postoperative follow-up,no significant differences were observed in scrotal edema,hydrocele,incision infection,testicular atrophy,or recurrence rates between the two groups.At 12 months postoperatively,the laparoscopic group had lower testicular location than the open surgery group.In Group A,there was no significant difference in testicular volume between the two surgical approaches,while in Group B,the laparoscopic group had larger testicular volume than the open surgery group(P=0.007).Conclusions:Both laparoscopic and open orchiopexy are effective for treating inguinal cryptorchidism.Laparoscopic surgery o ffers faster recovery,better cosmetic outcomes,fewer complications,and superior testicular descent compared to open surgery.Children aged 0.5~1.5 years who underwent surgery has lower complication rate than those aged 1.5~3 years.

关 键 词：隐睾 睾丸固定术 腹腔镜检查 开放手术 儿童 

分 类 号：R697.22[医药卫生—泌尿科学]